APPLICATION FOR PARTICIPATION IN ISU I-CORPS SITE PROGRAM

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APPLICATION FOR PARTICIPATION IN ISU I-CORPS SITE PROGRAM The goals of the ISU I-Corps Site program are to have participating teams gain industry exposure and entrepreneurial training through a four-week curriculum focused on customer discovery to support the transition of their ideas, devices, processes, or intellectual activities into the marketplace. This transition can be through the formation of new startup businesses, through licensing agreements, or through identifying funding sources to support additional research. Teams are composed of an entrepreneurial lead, academic lead, and mentor: Entrepreneurial Lead: The Entrepreneurial Lead will be a graduate student or postdoc with relevant technical knowledge and a desire and commitment to investigate the commercial landscape for the innovation. The Entrepreneurial Lead should also demonstrate interest in and be capable of taking the next steps towards commercialization if the innovation shows commercial potential, such as applying for participation in the I-Corps Teams program or the ISU Startup Factory. In certain situations, a second Entrepreneurial Lead may be included as part of the team. Academic Lead: The Academic Lead will be a faculty member, scientist, or other qualified staff member who has contributed to the research underlying the innovation and who has the expertise to serve as the technical lead and project manager. The Academic Lead must have an appointment that would qualify him or her to submit proposals or serve as a principal investigator on subsequent submission to NSF. Mentor: Mentors will be an experienced or emerging entrepreneur with exposure to technology transfer and proximity to ISU. Mentors may also be internal ISU staff members with entrepreneurial, industry, tech transfer, or other relevant experience. The Mentor role will be to guide the customer discovery process and offer support for the next step in commercialization (i.e., application to the I-Corps Teams program or ISU Startup Factory) if the innovation is demonstrated to have commercial potential. The Entrepreneurial Lead and Academic Lead may select their Mentor or may utilize the ISU Mentor Network to identify an appropriate Mentor. To apply for participation in the ISU I-Corps Site program, please complete the following application. Teams that are accepted into the program and participate in all sessions are eligible to receive a microgrant of up to $3,000 to support customer discovery efforts. Please email completed applications to Dr. Guru Rao, Associate Vice President for Research: gururao@iastate.edu. The application deadline for participation in the Fall 2017 cohort is September 29, 2017. Selected applications will be invited to participate in a review panel to make final determinations of cohort members. KEY PROGRAM DATES Applications accepted: September 11 29, 2017 Review Panels: October 9 20; exact dates TBD Notification of accepted applicants: October 20 Program kickoff: November 1, 5:30 7:30 pm Additional session dates: November 8, November 15, and November 29 (Attendance by the Entrepreneurial Lead and Academic Lead is required at all sessions to be eligible to receive a microgrant) Cultural Competency Workshop: TBD ISU I-Corps Site Program Application 1

SECTION 1. TEAM MEMBERS Please provide the name, position, academic department, and email address for each team member. Team Member 1: Entrepreneurial Lead Department Team Member 2: Academic Lead Department Team Member 3: Mentor (if you do not have a Mentor, you can access the Mentor Network to identify one and can still apply to participate) Department/Organization Team Member 4: Second Entrepreneurial Lead (optional) Department/Organization ISU I-Corps Site Program Application 2

SECTION 2. PROJECT AREA Please briefly list the scientific or technical area for the project (e.g., engineering, materials science, life science). SECTION 3. INVENTION DISCLOSURE Please check the appropriate box to indicate whether an invention disclosure been submitted to the Iowa State University Research Foundation. Yes No If yes, please provide the ISURF case number SECTION 4. PROJECT NARRATIVE In no more than 500 words (approximately 1 page), using the space provided on the following page, please provide a project narrative that addresses the following questions: What is the problem you would like to solve that will benefit society based on your research and development? Describe your main idea and approach to solve this problem. Why is it novel? What are the innovative claims both on the approach and solution? What is the current state of your research? What is your plan to make a transition into the marketplace? Are there any technology gaps that require further research? What will be the composition of your business team? Has the idea been publicly disclosed? (For example, has it been published or presented at a conference, lab meeting, or departmental seminar, or listed as part of a website? Has the concept been patented or has a patent application been applied for?) Please use Times New Roman 12 point font for the project narrative. Applications with a project narrative greater than 500 words or that do not use the specified font and font size may be returned without review. ISU I-Corps Site Program Application 3

ISU I-Corps Site Program Application 4

SECTION 5. ANTICIPATED DELIVERABLES In the space provided below, please briefly describe your anticipated deliverables if your team is selected to participate in the program. ISU I-Corps Site Program Application 5